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New Student History Form
We would like to learn more about your child so that we can provide him or her with the best educational experience. Thank you for taking the time to fill out this form. Thanks!
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* Indicates required question
Email
*
Your email
FAMILY INFORMATION
Child's Legal First Name
Your answer
Child's Legal Last Name
Your answer
Preferred Name
Name to be called at school.
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Grade Level
Kindergarten
1st Grade
2nd Grade
3rd Grade
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Parent 1 Full Name
Your answer
Parent 1 Email Address
Your answer
Parent 1 Phone Number
Your answer
Parent 2 Full Name
Your answer
Parent 2 Email Address
Your answer
Parent 2 Phone Number
Your answer
Child lives with
Parent 1 Only
Parent 2 Only
Both Parents
Other:
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Siblings (Name and Date of Birth)
Your answer
Is there another person in addition to the parents who provides care for the child on a regular basis?
Yes
No
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If yes, who take care of the child?
Please provide person's name, type and frequency of care.
Your answer
Have there been any significant changes in the home over the last year (i.e. separation/divorce deaths, moving)?
Yes
No
Clear selection
If yes, please explain.
Your answer
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